Individual provider Active NPI

Jonathan Edward Jensen, M.D.

  • Gastroenterology Physician
  • Kingsport, TN
National Provider Identifier
1598745002
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
69824 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone
(423) 224-4000
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 33738 CO
Gastroenterology Physician 207RG0100X 042-0014522 VT
Gastroenterology Physician 207RG0100X 69824 TN Primary

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3837

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

205 S Main St
Suite a
Longmont, CO 80501-1716
Phone (303) 776-6115

Other practice location 2

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other practice location 3

100 Hospital Ln Ste 100
Danville, IN 46122-1993
Phone (317) 745-7310

Other practice location 4

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group
Direct Messaging Address jjensen344535@direct-PRD.stelizabeth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, SC, MT, IL4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20191029002483 VT Practitioner - Gastroenterology 4587625074 Reassigns benefits to 1 organization
I20200706002985 SC Practitioner - GastroenterologyPractitioner - Internal Medicine 4587625074 Reassigns benefits to 1 organization
I20210524000139 MT Practitioner - Gastroenterology 4587625074 Reassigns benefits to 1 organization
I20250312003506 IL Practitioner - Gastroenterology 4587625074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy26
Upper gastrointestinal (GI) endoscopy for acid reflux77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0014522VTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Mar 7, 2025 Accepting new patients
Swedishamerican Hospital CurrentSince Mar 7, 2025 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Jan 28, 2021 Accepting new patients
University of Vermont Medical Center Inc CurrentSince Sep 15, 2019 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Jan 28, 2021 Accepting new patients
Swedishamerican Hospital Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jun 1, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jun 1, 2020 Accepting new patients

Locations

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

3 Richland Medical Park Dr
Ste 120
Columbia, SC 29203
Phone (803) 434-8866

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: jjensen344535@direct-prd.stelizabeth.com
  • Direct secure messaging: jjensen3947729@direct.trinity-health.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1598745002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-224-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 S Main St",
            "address_2": "SUITE A",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805011716",
            "country_code": "US",
            "telephone_number": "303-776-6115",
            "fax_number": "303-776-4318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "IN",
            "postal_code": "461221993",
            "country_code": "US",
            "telephone_number": "317-745-7310",
            "fax_number": "317-745-7320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207430",
            "country_code": "US",
            "telephone_number": "423-844-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "33738",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VT",
            "license": "042-0014522",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "69824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjensen344535@direct-PRD.stelizabeth.com",
            "affiliation": "N",
            "address_1": "100 Hospital Ln Ste 100",
            "city": "Danville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461221993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.